Report of the APSS Spine Travelling Fellowship 2013

Transcription

1 Report of the APSS Spine Travelling Fellowship 2013 Fellow : Dr. Sohail Ahmad Assistant Professor, Dept. of Orthopaedic Surgery J.N.Medical College,A.M.U. Aligarh, India Duration : 10 th 30 th ember, 2013 Attachements : 10 th 17 th ember Vo Van Thanh ( Vietnam ) 17 th 24 th ember - Munehito Yoshida (Japan) 24ht 30 th ember- Kee Yong Ha (South Korea ) I reached Ho Chi Minh city (HCM) in the night of 10 th. and was received by a young spine surgeon working with Van Thanh at the airport. Fellowship started from 11 th ember. Dr. An, Van Thanh s son and himself a spine surgeon picked us from the hotel and took us to the hospital for Trauma and Orthopaedics where we met Thanh and other members of his team. After a formal introduction we went for the hospital round to see its various sections and the facilities available there. Then we went with Thanh to meet the director of the hospital. In the afternoon we went to the operation theatre to observe a case of cervical myelopathy where Thanh did laminectomy (C3-C6) and posterior fixation with double plating.

2 Day ended with discussion about a case of scoliosis to be operated next day. 12 th ember :- day started with discussion about the emergency cases of the previous day, then we went to the conference room of the hospital where I presented my paper Results of discectomy by interlaminar fenestration technique in lumbar disc prolapsed which was well appreciated by the audience. Then we went to the operation room where two cases were lined up. One case was of T5 intradural tumour which was operated by a French visiting neurosurgeon Labierrie. Second case was of adolescent idiopathic scoliosis where Thanh and his team members did deformity correction. In both the cases we got a chance to scrub and actively participate in the operation. In the evening we went for the welcome dinner with Prof Thanh and his team members along with Labierrie in a traditional Vietnamese s restaurant. On 13 th ember again in the morning we had discussion about previous day emergencies in the chamber of Thanh and then we went to the conference room where Dr. Philip presented his paper on cervical laminoplasty. Then we went for the ward round with Thanh and had detailed discussion about the cases admitted there in the ward and about the preoperative planning of the patients waiting for operation. Then we went to the outpatient clinic with Thanh where we saw different type of spine cases that came to him from different parts of the country. Next day (14 th.) started with emergency case discussion and paper presentation by Dr. Ankit Gupta in the conference

3 room. Then we went to the operation theater where we assisted a case of severe scoliotic deformity. Thanh did second stage deformity correction with posterior instrumentation. He introduced us to his technique of pedicle screw insertion without using C- arm and also gave us an opportunity to practice it on his patient. In the evening he took us to a vegetarian restaurant for farewell dinner. On 15 th ember after the morning discussion we directly went to the operation theater where a case of cervical myelopathy was posted for operation. We scrubbed with Dr. Hien, a member of Thanh spine team and assisted him in cervical laminoplasty by VT technique. It was a nice experience to see this new technique of cervical laminoplasty. In the afternoon we went for the city tour to experience the Vietnamese culture and traditions. On 16 th ember Prof Thanh took us to his native place which was around 100 km from the HCM. Thanh s wife especially prepared vegetarian food for us. We had lunch with them at their house and went to visit local temple and the city. In the evening we returned to HCM and stayed at his house for sometime where we met other members of his family. Then Prof Thanh himself accompanied us to the airport where we took a flight for Japan. We reached Kansai International Airport in the morning of 17 th. where we were received by Dr. Hiroshi who took us for a city tour of as hotel check- in time was 3 pm and plenty of time was left. We had lunch with him in a vegetarian Japanese restaurant and then he dropped us to the hotel.

4 On 18 th ember Dr. Hiroshi took us to the Medical University. We went to the conference room of the Orthopaedics department where we met Yoshida and his team members. After the morning conference we went for the ward rounds with Yoshida where he showed us different type of spine cases admitted in the ward. After finishing the ward rounds we went to Yoshida s outpatient clinic where we had a very informative discussion with him about different aspects of spine surgery and their philosophy of management of spinal canal stenosis. After taking lunch with Yoshida we went to Saise Kai with Dr. Hiroshi. There we observed two cases being operated by Dr. Yamada where he did microendoscopic lumber spine decompression in one patient and cervical laminoplasty in another. In the evening again Dr. Hiroshi picked us from the hotel and took us to the hospital where we all presented our papers in the conference room of the department and had a detailed discussion about the presentations. On 19 th ember we went to the Sumiya Orthopaedic where we observed three cases of spine operated by Yoshida and his team members. Prof Yoshida discussed the various aspects of microendoscopic spine surgery. In the evening we went for a welcome dinner at traditional Japanese restaurant where we met all the members of the Yoshida s spine team. It was a nice moment for all of us to experience the culture and traditions of the Japanese people. 20 th ember :- day started with morning seminar in the conference room of the department and then we went to the operation theater where we observed four cases of

5 microendoscopic spine surgery done by Yoshida and his team members. On 21 st ember we were taken to Kihoku hospital, another hospital of Medical University which was about 100 km from the city. There we met another very senior and experienced spine surgeon Kawakami. We scrubbed with Kawakami in two cases of spine surgery. In one case of lumbar spine stenosis he demonstrated Modified Marmoth technique of lumbar canal decompression. In the evening we had dinner with Kawakami and his team members and after the dinner Dr. Hiroshi drove us to the Kobe city. Next day ( 22 nd.) we went to attend the 16 th annual conference of JESMIS 2013 with Yoshida and Dr. Hiroshi. On 23 rd ember Dr. Hiroshi took us to Keoto, a beautiful city near Osaka. There we enjoyed the beautiful landscape and other sight seeing spots. We returned to city in the evening of 23 rd. and left the city in the morning of 24 th. to catch the flight to South Korea. We reached Seoul in the afternoon of 24 th ember where Dr. Ahn received us at the airport and took us to the guest house of the Seoul St Mary. On the 25 th ember Miss. Susana took us to the conference room of the Orthopaedic department where we met Dr. Kim and other members of the Orthopaedic Department. After finishing the morning seminar we went to the outpatient clinic to meet Kee Yong Ha, and then Dr. Ahn took us to the different sections of the hospital and for the ward rounds. In the afternoon we went to the operation theater where we observed Dr. Kim operating a patient of sacral chordoma. Next morning

6 (26 th.) after finishing the morning conference we went to the operation room where we observed/assisted Dr. Kim who operated two patients of spine where he did PLIF L4-L5 and DLIF L2-L4. In the afternoon we scrubbed with Ha who performed two cases again one PLIF and one DLIF. He discussed the steps of DLIF in detail and showed us how to do it. On th ember we directly went to the operation room where we first assisted Ha in two cases of spine where he did DLIF in one patient and PLIF in the other patient. In the afternoon we observed Dr. Kim giving transforaminal epidural injections in ten patients. Next day (28 th.) started with attending morning spine conference form 7am to 8 am and then we went for the city tour with Dr. Ahn. We went to see different palaces and the museum and experienced the tradition and culture of the Korean people. In the evening we had dinner in an Indian restaurant with Ha and his wife. They tried few Indian dishes and liked the taste of Indian curry and tandoori chicken. On 29 th. we directly went to the operation room in the morning where we assisted Ha in two cases of spinal surgery. In the evening we went to the out patient clinic where Ha presented us the certificates of the fellowship. On 30 th ember we checked out from the guest house of the hospital to catch the flight back to India. My three weeks of stay in Vietnam, Japan and South Korea was extremely satisfying. I would like to express my heartfelt gratitude to Vo Van Thanh of Vietnam, Prof Munehito Yoshida of Japan, Kee Yong Ha of Korea and other

7 consultants from the affiliated hospitals for having organized such an academically enriched programme and taking extra efforts to teach us and share their skills, technique and experience. Finally I would like to thank Asia Pacific Spine Society, especially the chairman; Arvind jayaswal, Secretary; Prof Kwan Mun Keong for selecting me for this fellowship and giving me this opportunity to visit the centre of excellence and interact with stalwarts of spine surgery. I would also like to thank Ms Y.M.Kong and Helen Chong for coordinating the fellowship programme.

8 1a - With Thanh in his office 1b - Having dinner with Thanh and other members of his team 1c Scrubbed with Thanh 1d With Dr. Hien in OT 1e Receiving certificate 1f Having lunch at Thanh s house

9 2a- With Yoshida at 2b Welcome dinner with Sumia Yoshida and his team members 2c With Kawakami and his team members 2d Scrubbed with Kawakami at Kihoku 2e Attending JESMISS 2013 With Dr. Hiroshi at Kobe 2f Having lunch with Yoshida and Dr. Hiroshi

10 3a With Ha after morning conference 3b - With Dr. Ann at Secret garden 3c With Ha and his wife at an Indian restuarant 3d With Ha and his team after receiving certificates at his office

11 Log Book Date Age Sex Diagnosis Procedure Surgeon Role F Cervical myelopathy Thanh F T5 intra-dural tumour C3 to C6 laminectomy with fusion by plating T5 hemilaminectomy with tumour excision 11 M AIS Posterior instrumentation (T2 to L2) Double rod rotation technique 17 M AIS Posterior instrumentation (T1 to L4) + Multiple SPO 70 M Cervical myelopathy with OYL Cervical C3 to C6 laminoplasty F PID Microendoscopic discectomy and decompression F Cervical myelopathy 74 F L5/S1 foraminal stenosis + T10/11 OYL 57 M Recurent PID L L5/S1 C3 to C7 double door laminoplasty Microscopic L5/S1 transforminal endoscopic decompression + T10/11 open laminectomy Microendoscopic fenestration and discectomy Lapierrie Thanh Thanh Assist Assist Assist Trauma, HCM City for Trauma Orthopedics, HCM city for Trauma Orthopedics, HCM city for Trauma Orthopedics, HCM city Dr. Hien Assist for Trauma Orthopedics, HCM city Yamada Yamada Yashida + Dr Nomura Dr. Nomura Saiseikai Saiseikai Sumiya Orthopaedic Sumiya Orthopaedic

12 19 45 M Recurent PID L Microendoscopic fenestration and discectomy Dr. Nomura Sumiya Orthopaedic M R lateral canal stenosis 52 F R L2 extraforminal radiculopathy 70 M R far lateral disc with R L4 radiculopathy 12 F Basal skull and C1/2 compression with syringomyelia 61 F Spinal stenosis L3/4 and 67 F Spinal stenosis L2/3, L3/4, and L5/S1 Microendoscopic R lateral canal decompression by posterior approach Microendoscopic transforminal R L2 decompression Microendoscopic transforminal R L4 decompression and diskectomy FM decompression, C1 laminetomy, C2 laminoplasty + Duroplasty L3/4 and decompression + PL fusion L3 to L5 Modified Marmot operation L2 to S1 Yamada Yashida Dr. Hashizume Yamada Kawakami Prof Kawakami Assist Assist Medical University Medical University Medical University Medical University Medical University Kihoku Medical University Kihoku The 16 th Annual Meeting of the Japanese Society for the Study of Endoscopic and Minimally Invasive Spine Surgery JESMISS Kobe City 42 M Cordoma lower sacrum 79 F Degenerative scoliosis 71 M Spinal stenosis L3/4 and F Degenerative scoliosis 59 F Low grade lytic spondylisthesis En bloc excision posterior approach DLIF L2/3 and L3/4 PLIF and PL fusion L3 to L5 DLIF L1/2 and L2/3 Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Ha Assist Seoul St Mary s PLIF L5/S1 Prof Ha Assist Seoul St Mary s

13 L5/S F Spinal stenosis 80 F Spinal stenosis 73 F Spinal stenosis L2 to L5 Open laminectomy Posterior decompression + PL fusion PLIF L3/4 and, PL fusion L2 to L5 and posterior decompression 48 F PID Transforminal 53 F PID 4/5 Transforminal 66 F PID L5/S1 Transforminal 71 F Spinal stenosis Transforminal 80 F Spinal stenosis Transforminal 54 F PID Transforminal 67 F Spinal stenosis Transforminal 68 M Lateral canal Transforminal stenosis 83 F Spinal stenosis Transforminal 77 M Spinal stenosis Transforminal L5/S1 Prof Kim Seoul St Mary s Prof Ha Assist Seoul St Mary s Prof Ha Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s Prof Kim Seoul St Mary s